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Nowadays, in the higher education sector, the quality measurement process of education-related services is assuming a crucial role to support focused and targeted improvement activities deeply centered on students' needs/necessities. These are considered crucial factors for dealing with the current academic competitive context. Therefore, the quality measurement process has to be precise and accurate, namely the measurement model on which it is based has to be parsimonious and robust. The present work proposes an effective and easy-to-use methodological approach suitable for supporting the structuring of a measurement tool. Its effectiveness is shown with reference to the academic e-service provided at the University of Palermo. In particular, taking into account the students' viewpoints and perspectives, a measurement model of the academic e-service quality is developed and validated, thus overcoming the lack of literature on the subject. Finally, a survey is conducted, and highlighted academic e-service quality shortcomings and criticalities are stressed and discussed. The outcomes of this study may be of interest to practitioners and researchers in the field, offering important suggestions on how to support the structuring of a measurement model, as well the data-driven service quality improvement process.

Background: Internship represents the context for nursing students to acquire professional skills. The mutual relationship between the intern and the tutor, where both parties have the opportunity to grow and develop, contributes to transforming theoretical knowledge into intellectual, psychomotor, and social skills. However, the gap between education and clinical practice... [ABSTRACT FROM AUTHOR]

Background: Oncology nurses support cancer patients in meeting their self-care needs, often neglecting their own emotions and self-care needs. This study aims to investigate the variations in the five facets of holistic mindfulness among Italian oncology nurses based on gender, work experience in oncology, and shift work. Method: A cross-sectional study was carried out in 2023 amongst all registered nurses who were employed in an oncology setting and working in Italy. Results: There were no significant differences in all five facets of holistic mindfulness (p ≥ 0.05) according to gender, work experience in the oncology field, and shift work. Conclusion: Could holistic mindfulness be defined as an intrinsic individual characteristic? Surely, more insights will be necessary to better define the holistic trend in oncology nursing. [ABSTRACT FROM AUTHOR]

Introduction: The image of a nurse is a source of concern due to its impact on recruitment into the profession, political decisions about the profession, and how the image affects nursing practice. For these reasons, one of the long-term challenges is to assess and maintain a favorable public image that respects the utility and value of the nursing profession. Aim: This study aims to validate an instrument for assessing the image of the nurse as perceived by Italian citizens. Methods: A non-probabilistic sample of 564 people participated in the study between 2022 and 2023. Sociodemographic information of the Italian citizens was collected, and the instrument used to evaluate the perceived public image was the Nursing Attitudes Questionnaire (NAQ). The psychometric properties of the Italian version of the NAQ (NAQ-IV) were calculated using Cronbach's alpha, item–total correlations, skewness, and kurtosis. Factor analysis was performed using principal axis factoring and the varimax rotation method. Results: Factor analysis revealed a four-factor model explaining more than 60.52% of the variance, with the largest variance explained by the "Role and Professionalism" factor (34.08%). The internal consistency calculation showed a Cronbach's alpha of 0.89 for the scale and between 0.88 and 0.89 among the factors; all the items verified the item–total correlation and response variability criteria. Conclusions: The NAQ-IV could be a valid tool for assessing the perception of Italian citizens. However, further studies are recommended to evaluate the reliability of the instrument, especially in the evolving professional profile and social health welfare. [ABSTRACT FROM AUTHOR]

Purpose: The primary aim of this study was to evaluate whether the internal (session rating of perceived exertion [sRPE] and Edwards heart-rate-based method) and external training load (jumps) affect the presession well-being perception on the day after (ie, +22 h), according to age and tactical position, in elite (ie, Serie A2) female volleyball training. Methods: Ten female elite volleyball players (age = 23 [4] y, height = 1.82 [0.04] m, body mass = 73.2 [4.9] kg) had their heart rate monitored during 13 team (115 individual) training sessions (duration: 101 [8] min). Mixed-effect models were applied to evaluate whether sRPE, Edwards method, and jumps were correlated (P ≤.05) to Hooper index factors (ie, perceived sleep quality/disorders, stress level, fatigue, and delayed-onset muscle soreness) in relation to age and tactical position (ie, hitters, central blockers, opposites, and setters). Results: The results showed a direct relationship between sRPE (P <.001) and presession well-being perception 22 hours apart, whereas the relationship was the inverse for Edwards method internal training load. Age, as well as the performed jumps, did not affect the well-being perception of the day after. Finally, central blockers experienced a higher delayed-onset muscle soreness than hitters (P =.003). Conclusions: Findings indicated that female volleyball players' internal training load influences the pretraining well-being status on the day after (+ 22 h). Therefore, coaches can benefit from this information to accurately implement periodization in a short-term perspective and to properly adopt recovery strategies in relation to the players' well-being status. [ABSTRACT FROM AUTHOR]

Nursing research is rapidly increasing, yet contributions from numerous countries that may interest the international nursing community are impeded because many research articles are published in authors' native language and not in English. The objectives of this work were to systematically review papers published in Italian related to job satisfaction and the quality of nursing care, and to discuss their findings in light of the international literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used. The Directory of Open Access Journals (DOAJ) and Indice della Letteretura Italiana di Scienze Infermieristiche (ILISI) databases were consulted for eligible studies published from January 2015 to November 2022. Two hundred sixteen papers were identified, 11 of which were selected for review: 8 on job satisfaction, two on workload issues, and 1 on quality of nursing care. The quality of included studies was assessed through the Effective Public Health Practice Project quality assessment tool (EPHPP). The results of our review were in line with those of international literature, and they can help to fill the knowledge gap on the quality of nursing performance in Italian care settings. In addition, the proposed method can provide further elements of discussion among literature providers and reviewers. [ABSTRACT FROM AUTHOR]

Aim: Measuring the phenomenon of gambling and Internet addiction, with analysis of attitudes and psychophysical consequences among nurses working in different care settings. Methods: An observational, cross sectional, multicenter study was conducted from April to September 2020. Participants' socio-demographic information, the "Internet Addiction Test" (IAT) scale, and the "South Oaks Gambling Screen" (SOGS) were collected in order to assess the overuse of and whether an individual has a problematic relationship with gambling, respectively. Results: 502 nurses were enrolled in the study. Significant correlations were found (p <.001) between the IAT score and gender, number of years of work experience, job role, educational qualification; and between the SOGS and gender, number of years of work experience, job role and regions of Italy. Conclusions: The study highlighted an emerging social problem, and the results may be just the tip of the iceberg. Given the lack of knowledge of these phenomena and a high percentage of people who suffer from them but are afraid to admit it and get help, this study could also be useful in expanding knowledge and allow more professionals to get help and learn about possible treatments and cures for the resolution of these addictions. [ABSTRACT FROM AUTHOR]

Background. The COVID-19 pandemic has transformed people's lifestyles by imposing social, economic, and labor changes. Health professionals have been in the spotlight, occasionally even elevated to the status of "heroes", as they have been at the forefront of the health emergency. Media exposure has undoubtedly played a pivotal role in the evolution and perception of the public's image of nurses, especially within the Italian context. Currently, there is only one study conducted in Italy during the pandemic period. For this reason, we have opted to delve further into this subject during the post-pandemic period, with the ultimate goal of identifying this perceptual evolution. Methods. An online snowball sampling survey was conducted among the Italian population using social networks between August 2022 and January 2023. The survey utilized the Nursing Attitude Questionnaire (NAQ) to collect data. Results. The sample consisted of 564 individuals. Among the respondents, 63.8% (n = 360) were familiar with the nursing pathway, and the level of agreement regarding the training of nurses was 81.5% (n = 260). In terms of recognizing the professional role of nurses, variations emerged in certain domains of the NAQ. Specifically, professional values of nurses were more pronounced in northern and central Italy (M = 26.27). Moreover, stereotypes were more prevalent in the north (23.73 ± 3.538) and the center (23.13 ± 4.104) (p = 0.001). Conclusions. The sample acknowledged a unique competence inherent to nurses that cannot be replaced by other professionals. The study population perceives the nursing profession as pivotal within the IHS (Integrated Health System). However, the attractiveness of the profession remains exceedingly low. This study was not registered on a publicly available registry. [ABSTRACT FROM AUTHOR]

Background: There is minimal information regarding sleep disturbance and burnout during COVID-19 in nurses working within haematology-oncology and hematopoietic stem cell transplantation (HSCT) settings. Aim: To identify socio-demographic and professional factors that predicted burnout and sleep disturbance during COVID-19 in nurses working in HSCT settings. Design/Methods: Data were collected using the Maslach Burnout Inventory and the Pittsburgh Sleep Quality Index. Descriptive statistics and linear regression examined relationships. Results: 308 responses were received. Nurses working in outpatient settings had greater emotional exhaustion (Rpartial = −0.12, n = 308, p = 0.03). Negative predictors for quality of sleep were transplant programme setting (Rpartial = −0.19, n = 308, p < 0.01) and years working in HSCT (Rpartial = −0.17, n = 308, p < 0.01). Other relationships were found on univariate analysis. Conclusion: Institutions must offer programmes for nurses to develop sleep strategies, self-care, and work-related stress management. [ABSTRACT FROM AUTHOR]

Introduction: The study of immune response to SARSCoV-2 infection in different solid organ transplant settings represents an opportunity for clarifying the interplay between SARS-CoV-2 and the immune system. In our nationwide registry study from Italy, we specifically evaluated, during the first wave pandemic, i.e., in nonvaccinated patients, COVID-19 prevalence of infection, mortality, and lethality in liver transplant recipients (LTRs), using non-liver solid transplant recipients (NL-SOTRs) and the Italian general population (GP) as comparators. Methods: Case collection started from February 21 to June 22, 2020, using the data from the National Institute of Health and National Transplant Center, whereas the data analysis was performed on September 30, 2020. To compare the sex- and age-adjusted distribution of infection, mortality, and lethality in LTRs, NL-SOTRs, and Italian GP we applied an indirect standardization method to determine the standardized rate. Results: Among the 43,983 Italian SOTRs with a functioning graft, LTRs accounted for 14,168 patients, of whom 89 were SARS-CoV-2 infected. In the 29,815 NLSOTRs, 361 cases of SARS-CoV-2 infection were observed. The geographical distribution of the disease was highly variable across the different Italian regions. The standardized rate of infection, mortality, and lethality rates in LTRs resulted lower compared to NL-SOTRs [1.02 (95%CI 0.81-1.23) vs. 2.01 (95%CI 1.8-2.2); 1.0 (95%CI 0.5-1.5) vs. 4.5 (95%CI 3.6-5.3); 1.6 (95%CI 0.7-2.4) vs. 2.8 (95%CI 2.2-3.3), respectively] and comparable to the Italian GP. Discussion: According to the most recent studies on SOTRs and SARS-CoV-2 infection, our data strongly suggest that, in contrast to what was observed in NL-SOTRs receiving a similar immunosuppressive therapy, LTRs have the same risk of SARS-CoV-2 infection, mortality, and lethality observed in the general population. These results suggest an immune response to SARS-CoV-2 infection in LTRS that is different from NL-SOTRs, probably related to the ability of the grafted liver to induce immunotolerance. [ABSTRACT FROM AUTHOR]

The health profile of foreigners in Italy is affected by multiple factors and events, including environmental, microbiological, cultural, and behavioral. To explore nurses' basic cross-cultural knowledge, and their perceptions of problems that arise in encounters with clients from outside the country, and to suggest solution strategies, we enrolled 327 nurses in an observational, cross-sectional, multicenter study. The findings suggested a need to improve sociocultural skills related to working in a multiethnic society, as early as the first level courses and possibly continue with appropriate master's degrees and research projects. [ABSTRACT FROM AUTHOR]

Falls are the most frequent adverse events recorded in healthcare facilities. By employing a multifaceted strategy to ensure prevention interventions that are specific to the patient type and environmental risk management, risk factor evaluation may help to reduce falls in the hospital setting. Patient falls are one of the main causes of lawsuits against hospitals, which has led to the development of validated instruments that are beneficial in treating the patient after the incident and effective in minimizing the frequency of falls. The aim of our study is to evaluate compensation claims asserting healthcare culpability in situations where a patient fell in a hospital setting. The collected data relate to judgments issued in Italy until December 2022 regarding 30 episodes of falls that occurred between 2003 and 2018. Our research revealed that approximately 50% of Italian healthcare organizations lose the case in court when a patient falls in a hospital setting and dies or is injured. In half of these cases, the failure of the medical staff to use protective equipment against falls is what led to the court's acceptance of the compensation claim. In order to improve the quality of healthcare services, fall prevention techniques must continue to be implemented. [ABSTRACT FROM AUTHOR]

This essay reviews Alessandro Barbano's book L'inganno. Antimafia. Usi e soprusi dei professionisti del bene (2022), and questiones this author's sharp critics on Antimafia policy in Italy, and overall on the seizures of assets belonging to presumed Mafiosi, according to the existing laws. [ABSTRACT FROM AUTHOR]

Widespread contamination of the superficial, drinking, and groundwater by perfluoroalkyl substances (PFASs) was discovered in the Veneto Region (northeast of Italy) in 2013. Mothers from the contaminated area were concerned about the effects of PFAS on their own and their children's health. We determined the factors that influenced the perceived risk of PFAS and the presence of self-reported diseases by conducting a study with 384 mothers of children aged 1–13 years living in the contaminated area (Red Zone, Veneto, Italy). Information on demography, the sources of exposure, and the health condition of the mothers was collected through an online survey. The serum PFAS concentration was recorded for some of the participants. We determined the factors influencing the perceived risk, risk of health outcomes, and serum PFAS levels through regression analyses. The PFAS perceived risk of the mothers increased with an increase in the trust in scientific institutions and social media, and when many friends were present, trust in politics and full-time employment had a protective effect. The PFAS perceived risk increased the occurrences of self-reported and autoimmune diseases. Longer residence (> 20 years) in the most exposed area (Red Zone A) increased the frequency of some health outcomes. Serum PFAS concentrations decreased with breastfeeding, but increased with tap water consumption, residence in Red Zone A, and residence time. The PFAS perceived risk of the mothers was associated with many factors that influenced reporting of health issues. The association between PFAS exposure and health outcomes needs further investigation. [ABSTRACT FROM AUTHOR]

COVID-19 is strongly influenced by age and comorbidities. Acute kidney injury (AKI) is a frequent finding in COVID-19 patients and seems to be associated to mortality and severity. On the other hand, the role of kidney dysfunction in COVID-19 is still debated. We performed a retrospective study in a cohort of 174 hospitalized COVID-19 patients in Italy from March 3rd to May 21st 2020, to investigate the role of kidney dysfunction on COVID-19 severity and mortality. Moreover, we examined in depth the relationship between kidney function, age, and progression of COVID-19, also using different equations to estimate the glomerular filtration rate (GFR). We performed logistic regressions, while a predictive analysis was made through a machine learning approach. AKI and death occurred respectively in 10.2% and 19.5%, in our population. The major risk factors for mortality in our cohort were age [adjusted HR, 6.2; 95% confidence interval (CI) 1.8–21.4] and AKI [3.36 (1.44–7.87)], while, in these relationships, GFR at baseline mitigated the role of age. The occurrence of AKI was influenced by baseline kidney function, D-dimer, procalcitonin and hypertension. Our predictive analysis for AKI and mortality reached an accuracy of ≥ 94% and ≥ 91%, respectively. Our study scales down the role of kidney function impairment on hospital admission , especially in elderly patients. BIS-1 formula demonstrated a worse performance to predict the outcomes in COVID-19 patients when compared with MDRD and CKD-EPI. [ABSTRACT FROM AUTHOR]

Making ethical decisions in the context of a pandemic emergency due to the limited availability of healthcare resources is a pervasive problem that health organizations are trying to counter. As the coronavirus disease emerged worldwide, some countries were experiencing unanticipated challenges regarding resource allocation. While some were consistent with following the ethical guidelines in allocating these scarce resources, others acknowledged a different approach in their respective jurisdictions. A committee in Italy recognized the need to set an age limit for ICU admissions after seeking ethical counsel because the demand for critical care surprisingly exceeded supply. On the other hand, Philippine healthcare systems responded in a way that is not the same. They allocate resources reasonably and seek help from the Philippine government to avoid the scarcity dilemma. This paper will explore how scarce medical resources should be administered by healthcare systems without leaving the elderly behind. Afterward, this gives a possible approach to be taken in dealing with pandemics and other emergencies in the future. This paper will argue that in public health emergencies, age is an irrelevant characteristic when determining healthcare resource allocation amid the COVID-19 pandemic, and decisions should not be based on how scarce resources are. This paper supports an egalitarian view, specifically John Rawls' theory of justice, to ease the deep-rooted ageism in societies. The author believed that overlooking the most vulnerable populations during the pandemic must not be perpetuated despite the lack of preparedness for this sudden public health emergency. [ABSTRACT FROM AUTHOR]

Background and objective: Northern Italy was one of the first European territories to deal with the Coronavirus Disease 2019 (COVID-19) outbreak. Drastic emergency restrictions were introduced to contain the spread and limit pressure on healthcare facilities. However, nurses were at high risk of developing physical, mental, and working issues due to professional exposure. The aim of this cross-sectional study was to investigate these issues among nurses working in Italian hematopoietic stem cell transplant (HSCT) centers during the COVID-19 pandemic. Methods: Data were collected online immediately after the first "lockdown" period in order to investigate the prevalence of physical issues, sleep disorders, and burnout symptoms and explore correlations with COVID-19 territorial incidence in Northern Italian regions versus Central and Southern Italian regions. Results: Three hundred and eight nurses working in 61 Italian HSCT Units responded to the survey. Depression, cough, and fever were more frequently reported by nurses working in geographical areas less affected by the pandemic (p=0.0013, p<0.0001, and p=0.0005 respectively) as well as worst sleep quality (p=0.008). Moderate levels of emotional exhaustion (mean±SD - 17.4±13.0), depersonalization (5.3±6.1), and personal accomplishment (33.2±10.7) were reported without significant differences between territories. Conclusions: different COVID-19 incidence among territories did not influence nurses' burden of symptoms in the HSCT setting. However, burnout and insomnia levels should be considered by health care facilities in order to improve preventive strategies. [ABSTRACT FROM AUTHOR]

In the context of seismic risk, studying the characteristics of urban soils and of the built environment means adopting a holistic vision of the city, taking a step forward compared to the current microzonation approach. Based on this principle, CLARA WebGIS aims to collect, organize, and disseminate the available information on soils and buildings in the urban area of Matera. The geodatabase is populated with (i) 488 downloadable geological, geotechnical, and geophysical surveys; (ii) geological, geomorphological, and seismic homogeneous microzone maps; and (iii) a new Digital Surface Model. The CLARA WebGIS is the first publicly available database that reports for the whole urban area the spatial distribution of the fundamental frequencies for soils and the overlying 4043 buildings, along with probability levels of soil-building resonance. The WebGIS is aimed at a broad range of end users (local government, engineers, geologists, etc.) as a support to the implementation of seismic risk mitigation strategies in terms of urban planning, seismic retrofitting, and management of post-earthquake crises. We recommend that the database be managed by local administrators, who would also have the task of deciding on future developments and continuous updating as new data becomes available. [ABSTRACT FROM AUTHOR]

Context: The assessment of internal training load (ITL) using the session rating of perceived exertion (session RPE) has been demonstrated to provide valuable information, also in team sports. Nevertheless, no studies have investigated the use of this method during youth water polo training. Purpose: To evaluate youth water polo training, showing the corresponding level of reliability of the session-RPE method. Methods: Thirteen male youth water polo players (age 15.6 ± 0.5 y, height 1.80 ± 0.06 m, body mass 72.7 ± 7.8 kg) were monitored during 8 training sessions (80 individual training sessions) over 10 d. The Edwards summated heart-rate-zone method was used as a reference measure of ITL; the session-RPE rating was obtained using CR-10 scale modified by Foster. The Pearson product-moment was applied to regress the Edwards heart-rate-zone method against CR-10 session RPE for each training session and individual data. Results: Analyses reported overall high ( r = .88, R2 = .78) and significant (P < .001) correlations between the Edwards heart-rate and session-RPE methods. Significant correlations were also shown for each training session (r range .69-92, R2 range .48-85, P < .05) and individual data (r range .76-.98, R2 range .58-97, P < .05). Discussion: The results confirmed that the session-RPE method as an easy and reliable tool to evaluate ITL in youth water polo, allowing coaches to efficiently monitor their training plans. [ABSTRACT FROM AUTHOR]

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Purpose: To anticipate outstanding athletic outcomes, the selection process of elite athletes simultaneously considers psychophysiological and technical parameters. This study aimed to investigate whether selected and nonselected athletes for the Italian national taekwondo team could be discriminated by means of sport- specific performances and psychophysiological responses to training. Participants: 5 established Italian national athletes and 20 elite Italian taekwondo black belt athletes (9 women, 16 men; age 23.0 ±3.1 y; body mass 67.0 ± 12.1 kg). Methods: To update the Italian national-team roster, the 20 elite athletes participated in a 1-wk selection camp (7 training sessions). Selected athletes (n = 10) joined established national athletes during the following 3-wk national training period (7 training sessions/wk). During the 1-wk selection camp, differences (P < .05) between selected and nonselected athletes in performances, heart-rate responses, blood lactate accumulation [La], subjective ratings of perceived exertion (session RPE), and mood were examined. During the 3-wk national training period, differences (P < .05) in mood between selected and established national athletes were investigated. Results: With respect to nonselected athletes, selected athletes responded better to training in terms of session RPE (P = .047) and [La] (P = .046). No difference in performance and mood between subgroups emerged. After the 3-wk national training period, differences (P = .035) emerged for confusion, with decreases in the established national athletes and increases for recently selected athletes. Conclusions: Session RPE and [La] seem to be more effective than psychological measures in discriminating between elite taekwondo athletes. Evaluation of mood could be effective in monitoring athletes' response to national training. [ABSTRACT FROM AUTHOR]

This study aimed to analyze the technical and tactical aspects of the Italian under-18 Academy Rugby Union in relation to different academies, regional tournaments, and game outcomes. A notational analysis (44 indicators) was performed on 16 games (2014-15 season) to evaluate strong differences (p ≤ 0.05; moderate-large effect sizes [ESs]) according to variables. Among academies, strong differences were showed for defensive breakdown, in which the defending support is much (range = 77-87%), equal (range = 11-32%), and less (range = 2-12%) numerous than the attacking support, total tackles (range = 64-122), and passes (range = 72-151), pass to possession ratio (range = 6-10), possession lost due to an error (range = 28-59%), and ball in play in own (range = 8-25%) and opponent (range = 7-31%) 22-m area indicators. For tournaments, effects emerged for offensive breakdown when the ball is used quickly using maximum 2 attacking supports (range = 20-30%) and is not used quickly (range = 28-41%), total penalty kicks (range = 11-16), and sequences period 0-10 (range = 26-35%) and 10-40 seconds (range = 47-55%). Conversely, winning and losing academies reported differences with small ESs. These results highlight that the technical and tactical aspects of the Italian under-18 Academy Rugby Union are quite homogeneous, suggesting that FIR coaching staffs are more oriented to players' skills than successful games. However, tactical and strength and conditioning coaches can benefit from the findings of this study, focusing training on cognitive, strength, and repeated sprint abilities with and without change of direction for improving the occurrence of "set pieces won/regained" and "ball in play in opponent 22 m area," which appear as the key of the game in this rugby competition level. [ABSTRACT FROM AUTHOR]

A novel fuzzy-based approach which combines ELECTRE III along with the Importance-Performance Analysis (IPA) is proposed in the present work to comparatively evaluate the service quality in the public healthcare context. Specifically, ELECTRE III is firstly considered to compare the service performance of examined hospitals in a noncompensatory manner. Afterwards, IPA is employed to support the service quality management to point out improvement needs and their priorities. The proposed approach also incorporates features of the Fuzzy Set Theory so as to address the possible uncertainty, subjectivity and vagueness of involved experts in evaluating the service quality. The model is applied to five major Sicilian public hospitals, and strengths and criticalities of the delivered service are finally highlighted and discussed. Although several approaches combining multi-criteria methods have already been proposed in the literature to evaluate the service performance in the healthcare field, to the best of the authors' knowledge the present work represents the first attempt at comparing service performance of alternatives in a noncompensatory manner in the investigated context. [ABSTRACT FROM AUTHOR]

The needs of community-dwelling stroke patients are often not fully addressed. The Global Stroke Community Advisory Panel had developed the Post Stroke Checklist (PSC) with the aim of standardizing long-term stroke assessment and consequently care of patients. PSC has been validated for UK and Singapore, and an Italian version has been proposed. The aim of this study is to assess the needs of community-dwelling Italian stroke patients using an online version of PSC. Secondary aim is to assess utility of PSC for patients and clinicians. The PSC was administered to a sample of 64 patients with stroke in Italy by general practioners. PSC is a questionnaire formed by 11 questions, each one covering a domain identified as important for patients' health. After administration of PSC, patient and clinician satisfaction with the PSC was assessed by a specific questionnaire. The PSC identified specific problems for patients related to a worsening from the last examination not evaluated by any specialist. The online PSC highlighted problems related to mood, (in 50% of sample), mobility (53.1%), spasticity (42.2%), and pain (37.5%). Both patients and clinicians provided good results about the utility of online PSC. The PSC was confirmed to be a useful tool for identifying the needs of community-dwelling patients with stroke. Particular attention should be deserved to problems related to mood, mobility, and hence participation to social life, pain, and spasticity. For taking into account these aspects, the online PSC can be a useful portable tool for clinicians. [ABSTRACT FROM AUTHOR]

On 24 August 2016 a strong earthquake (Mw = 6:0) affected central Italy and an intense seismic sequence started. Field observations, DInSAR (Differential INterferometry Synthetic-Aperture Radar) analyses and preliminary focal mechanisms, as well as the distribution of aftershocks, suggested the reactivation of the northern sector of the Laga fault, the southern part of which was already rebooted during the 2009 L'Aquila sequence, and of the southern segment of the Mt Vettore fault system (MVFS). Based on this preliminary information and following the stress-triggering concept (Stein, 1999; Steacy et al., 2005), we tentatively identified a potential fault zone that is very vulnerable to future seismic events just north of the earlier epicentral area. Accordingly, we planned a local geodetic network consisting of five new GNSS (Global Navigation Satellite System) stations located a few kilometres away from both sides of the MVFS. This network was devoted to working out, at least partially but in some detail, the possible northward propagation of the crustal network ruptures. The building of the stations and a first set of measurements were carried out during a first campaign (30 September and 2 October 2016). On 26 October 2016, immediately north of the epicentral area of the 24 August event, another earthquake (Mw = 5:9) occurred, followed 4 days later (30 October) by the main shock (Mw = 6:5) of the whole 2016 summer-autumn seismic sequence. Our local geodetic network was fully affected by the new events and therefore we performed a second campaign soon after (11-13 November 2016). In this brief note, we provide the results of our geodetic measurements that registered the co-seismic and immediately post-seismic deformation of the two major October shocks, documenting in some detail the surface deformation close to the fault trace. We also compare our results with the available surface deformation field of the broader area, obtained on the basis of the DInSAR technique, and show an overall good fit. [ABSTRACT FROM AUTHOR]

A conceptual model of the Academic Library (AL) service quality is hypothesized in the present article, and then validated and analyzed by a novel evaluation approach. Specifically, the conceptual model integrates the fundamental attributes of the canonical AL service together with those more relevant of the new and widely considered AL Electronic Service (e-services). As concerns the evaluation approach, it incorporates the Fuzzy Sets Theory (FST) so as to deal with the students' uncertainty over their own judgments on the AL service quality and a Structural Equation Model (SEM) to validate the conceptual model and to determine the key drivers of the AL service quality. The effectiveness of the proposed approach is proved by an empirical study concerning the AL of the Polytechnic School of the University of Palermo (Italy). Data collected via a survey involving more than 600 students are used, and the key drivers of the AL service quality are found out. Particularly, the obtained results reveal that Collections and materials represents the main driver of the AL service quality followed by Infrastructure and Access to the service, whereas Staff plays the fundamental role of interface between AL service aspects and students' needs and necessities. [ABSTRACT FROM AUTHOR]

On October 26th 2016, immediately north of the epicentral area affected by the Mw 6.0, August 24th earthquake, a strong earthquake (Mw = 5.9), with a focal mechanism showing W-dipping normal faulting, occurred at the boundary between Marche and Umbria regions (central Apennines, Italy). Four days later (on October 30th), the main-shock (Mw = 6.5) of the whole seismic sequence occurred in the same area. The central Apennines are characterized by northeast-verging thrust-propagation folds, involving Mesozoic- Tertiary sedimentary successions. During the 2016 sequence, coseismic deformation has been recorded at the rear of the Sibillini Thrust which separates the main mountain chain from the Marche-Abruzzi foothills (Fig. 1). This contractional structure has been partly dissected and/or inverted by NNW-SSE trending Quaternary normal and oblique-slip faults. The major event (October 30) induced extensive geological effects at the surface and structural damages in the broader epicentral area up to a distance of 30 km. According to the report of the Istituto Nazionale di Geofisica e Vulcanologia (SUMMARY REPORT ON THE 30 OCTOBER, 2016 EARTHQUAKE IN CENTRAL ITALY Mw 6.5, Gruppo di Lavoro INGV sul Terremoto in centro Italia 10 November 2016), the hypocenter of major event was located at 42.8322° N, 13.1107° E at a depth of 9.2 km (Figs. 1 and 2). Following the August seismic events, we installed five new geodetic points located on both sides of the principal fracture zone and carried out two campaigns of GNSS measurements, the first one at the end of September (30-09/02-10, 2016), the second one early November (11/13-11, 2016) that covered the period of the October events. [ABSTRACT FROM AUTHOR]

Background: Locking plate fixation is a reliable treatment for many displaced proximal humeral fractures. Carbon fiber-reinforced-poly-ether-ether-ketone (CFR-PEEK) plates have recently been introduced as an alternative to traditional metallic plates. Methods: In a multicenter study involving the Orthopedic Services of 6 Italian hospitals, 182 patients with a proximal humeral fracture were treated with a Diphos H (Lima Corporate, San Daniele del Friuli, Italy) CFR-PEEK plate, 160 of whom were followed clinically and radiographically for 2 years or more. Fractures were classified by Neer's system. The functional results were assessed by Constant and DASH scores. Results: The average time to radiographic healing was 5.6 months in 158 of 160 cases. Mean Constant score was 76, and mean DASH score was 28 at 2 years. There were two nonunions (one septic and one aseptic) and 13 cases of partial (9) or massive (4) humeral head necrosis. In three of the 78 patients treated with the first-generation plates, hardware breakage happened during the operation and the plate was replaced. There was no failure among the cases treated with the thicker second-generation plate. In eight cases, there was a perforation of the humeral head by the cephalic screws. Conclusions: CFR-PEEK plates proved as reliable as metallic plates in the treatment of proximal humeral fractures. The advantages of these new devices include a better visualization of fracture reduction during intraoperative fluoroscopic assessment and easy hardware removal due to the absence of screw-plate cold fusion. [ABSTRACT FROM AUTHOR]

Rule of law and the legality principle – Legality principle in the Italian legal system – ‘Prescribed by law’ – Legality in supranational dimension – ‘Democratic disconnect’ – Margin of appreciation – Concepts of ‘law’ and ‘legislation’ – Democracy-based legislation – Quality of legislation – ‘Political constitutionalism’ versus ‘legal constitutionalism’ [ABSTRACT FROM PUBLISHER]

The article discusses the individual and team time-motion analyses of Italian elite women's basketball games. Topics include low- and high-intensity activities (HIAs) in basketball, such as running and jumping, respectively, the evaluation of players’ movement patterns during HIA, sprint activity, and repeated sprint events (RSEs), the analyses of live time (LT), stoppage time (ST), and half- and full-court actions in teams, and the frequency at which changes of activities occurred.

Copyright of Kinesiologia Slovenica is the property of Faculty of Sport and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses the tactical and technical aspects of losing and winning teams in unbalanced and close women's water polo games, suggesting that water polo can be analyzed according to margins of victory. Topics include training, notational analysis, offensive even arrangements, and lost possessions.

Since late December 2019, severe acute respiratory syndrome coronavirus 2 has spread across the world, which resulted in the World Health Organization declaring a global pandemic. Coronavirus disease 2019 (COVID-19) presents a highly variable spectrum with regard to the severity of illness. Most infected individuals exhibit a mild to moderate illness (81%); however, 14% have a serious disease and 5% develop severe acute respiratory distress syndrome (ARDS), requiring intensive care support. The mortality rate of COVID-19 continues to rise across the world. Data regarding predictors of mortality in patients with COVID 19 are still scarce but are being actively investigated. The present multicenter retrospective observational study provides a complete description of the demographic and clinical characteristics, comorbidities and laboratory abnormalities in a population of 421 hospitalized patients recruited across eight infectious disease units in Southern Italy (Sicily) with the aim of identifying the baseline characteristics predisposing COVID-19 patients to critical illness or death. In this study, older age, pre-existing comorbidities and certain changes in laboratory markers (such as neutrophilia, lymphocytopenia and increased C-reactive protein levels) at the time of admission were associated with a higher risk of mortality. Male sex, on the other hand, was not significantly associated with increased risk of mortality. Symptoms such as fatigue, older age, a number of co-pathologies and use of continuous positive airway pressure were the most significant contributors in the estimation of clinical prognosis. Further research is required to better characterize the epidemiological features of COVID-19, to understand the related predictors of death and to develop new effective therapeutic strategies. [ABSTRACT FROM AUTHOR]

Background The reported incidence of biopsy-proven primary glomerulonephritis (PGN) varies according to geographical, temporal and environmental factors. Consequently, the development of national/regional registers may help clinicians and researchers to improve knowledge about this important clinical condition. Methods To better define the epidemiology of PGN in our North-Eastern Italian area (∼5 million inhabitants), we evaluated the kidney biopsy records of 2680 adult patients with PGN diagnosis reported from 1998 to 2010 in the ‘Triveneto’ Register of Renal Biopsies. Results Statistical analysis showed that the mean age of patients undergoing renal biopsy was gradually increased from 1998 to 2010 (R2 = 0.82, P < 0.01) with a growing percentage of those aged over 65 years (R2 = 0.72, P < 0.01). According to the clinical presentation of our PGN patients, we found a significant increase in biopsies performed for acute renal failure (P < 0.01) and a decrement of those for macroscopic haematuria (P < 0.01) and nephritic syndrome (P = 0.04). Moreover, although there has been an unchanged total annual rate of biopsy-proven PGN (P = 0.47), there has been a significant enhancement in the incidence of minimal change disease (MCD, P = 0.04) and extracapillary proliferative glomerulonephritis (ExGN, P = 0.03) over time primarily due to a progressive increase in the mean age of patients affected by both renal diseases. Immunoglobulin A (IgA) nephropathy was the most common glomerulonephritis. Conclusions Therefore, even if the number of PGN did not diminish during the 13-year study period, we reported considerable changes in the demographical and clinical characteristics of our biopsied patients (older and with acute kidney injury). Additionally, we found a change in the bioptic pattern of our patients over time with a progressive rise of some histological features such as MCD and ExGN. This may reflect not only the progressive ageing of our nephrology patients, but also a change in the biopsy policy of local hospitals. [ABSTRACT FROM AUTHOR]

Copyright of Kinesiologia Slovenica is the property of Faculty of Sport and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: In January 2010, the SICE (Italian Society of Endoscopic Surgery), under the auspices of the EAES, decided to revisit the clinical recommendations for the role of laparoscopy in abdominal emergencies in adults, with the primary intent being to update the 2006 EAES indications and supplement the existing guidelines on specific diseases. Methods: Other Italian surgical societies were invited into the Consensus to form a panel of 12 expert surgeons. In order to get a multidisciplinary panel, other stakeholders involved in abdominal emergencies were invited along with a patient's association. In November 2010, the panel met in Rome to discuss each chapter according to the Delphi method, producing key statements with a grade of recommendations followed by commentary to explain the rationale and the level of evidence behind the statements. Thereafter, the statements were presented to the Annual Congress of the EAES in June 2011. Results: A thorough literature review was necessary to assess whether the recommendations issued in 2006 are still current. In many cases new studies allowed us to better clarify some issues (such as for diverticulitis, small bowel obstruction, pancreatitis, hernias, trauma), to confirm the key role of laparoscopy (such as for cholecystitis, gynecological disorders, nonspecific abdominal pain, appendicitis), but occasionally previous strong recommendations have to be challenged after review of recent research (such as for perforated peptic ulcer). Conclusions: Every surgeon has to develop his or her own approach, taking into account the clinical situation, her/his proficiency (and the experience of the team) with the various techniques, and the specific organizational setting in which she/he is working. This guideline has been developed bearing in mind that every surgeon could use the data reported to support her/his judgment. [ABSTRACT FROM AUTHOR]

The article reports on research conducted to investigate the technical and tactical aspects of young athletes during official taekwondo competitions. Researchers evaluated 43 male and 16 female athletes. They found that there were no differences for gender and match outcomes, that all athletes engaged more frequently in offensive actions and that kicks with the rear leg were performed more frequently than kicks with the front leg.

The aim of this study was to investigate differences in athletes' (7 females, 10 males) motor performances (countermovement jump and handgrip) before and after official youth (13–14 years) taekwondo matches. Exercise load was evaluated by means of the heart rate responses during the match. Independent of round and gender, during the competitions mean heart rate was 187 beats·min−1 (s=11). During the match, the frequency of heart rate responses above 85% of an individual's maximum heart rate was 77% (s=27). Jump performances showed differences for gender (P=0.044; ES = 0.47) and its interaction with session (P=0.045; ES = 0.49). Female athletes' post-match countermovement performances were no different from their pre-match performances (pre and post: 22 cm, s=2), whereas male athletes post-match performances (28 cm, s=6) were better than their pre-match performances (25 cm, s=6). Handgrip performances related to the body mass of the athletes showed main effects for session (P=0.017; ES = 0.20) and for gender (P=0.026; ES = 0.47), with no significant interaction. Male athletes showed higher handgrip values (5.8 N·kg−1, s=0.6) than their female counterparts (5.1 N·kg−1, s=0.7). For absolute grip strength performances, values were higher pre-match (290.3 N, s=61.4) than post-match (272.4 N, s = 58.3). The heart rate responses indicate that official youth taekwondo competition imposes a high load on athletes. In particular, post-match decreases in isometric grip strength suggest that coaches should better prepare their very young athletes to prevent reductions in muscle force during fighting. Considering that lower limb power remained unaffected or increased depending on gender, further research in this area is strongly recommended. [ABSTRACT FROM AUTHOR]

The article discusses aspects of official 5-a-side youth soccer matches played on two pitch surface conditions such as the clay and artificial turf. It focuses on the level of heart rate (HR) responses and the analysis of the match including the number of players, shot precision, and lost balls. It reports that the youth soccer training program should use a multidisciplinary approach which include technical-tactical, psychological, and physiological contributions.

Background: Metabolic syndrome is a frequent condition that has been linked to cardiovascular disease (CVD) and mortality. Metabolic syndrome has been extensively shown to increase the risk of chronic nephropathies in Americans and Asians, but not in European populations. Renal disease increases the risk of CVD and mortality. However, the chronic nephropathy-CVD liaison has not been analyzed in the framework of the possible role of metabolic syndrome in both. Methods: We analyzed data from 3,757 subjects participating in the INCIPE survey (Initiative on Nephropathy, of relevance to public health, which is Chronic, possibly in its Initial stages, and carries a Potential risk of major clinical End-points), a cross-sectional study enrolling subjects from the general population in the Veneto region in Italy, and calculated the odds ratio (OR) and 95% confidence interval (CI) of the association between metabolic syndrome, and/or chronic kidney disease (CKD) and albuminuria, and/or previous CVD after adjustment for confounding factors. Results: Metabolic syndrome is associated with CKD (OR 2.17; P<0.001) and albuminuria (OR 2.28; P<0.001) and CVD (OR 1.58; P=0.002). There is a direct correlation between number of metabolic syndrome traits and nephropathy and CVD. CVD and nephropathies are associated even after adjustment for metabolic syndrome (OR 2.30; P<0.001). Conclusions: In a homogeneous Caucasian European population, metabolic syndrome is associated with CKD and albuminuria, and CVD. Although metabolic syndrome is a risk factor for both CVD and nephropathy, it does not entirely explain the dangerous CVD-nephropathy liaison. [ABSTRACT FROM AUTHOR]

Preterm infants need the achievement of adequate lung volume. Lung recruitment maneuver (LRM) is applied during high-frequency oscillatory ventilation. We investigated the effect of an LRM with positive end-expiratory pressure (PEEP) on oxygenation and outcomes in infants conventionally ventilated for respiratory distress syndrome (RDS). Preterm infants in assisted controlled ventilationþvolume guarantee for RDS after surfactant randomly received an LRM (group A) or did not (group B). LRM entailed increments of 0.2 cm H2O PEEP every 5 minutes, until fraction of inspired oxygen (FiO2)=0.25. Then PEEP was reduced and the lung volume was set on the deflation limb of the pressure/volume curve. When saturation of peripheral oxygen fell and FiO2 rose, we reincremented PEEP until SpO2 became stable. Group A (n=10) and group B (n=10) infants were similar: gestational age 25±2 versus 2±52 weeks; body weight 747±233 versus 737±219 g; clinical risk index for babies 9.8 versus 8.1; initial FiO2 56±24 versus 52±21, respectively. LRM began at 86±69 minutes of age and lasted for 61±18 minutes. Groups A and B showed different max PEEP during the first 12 hours of life (6.1±0.3 versus 5.3±0.3 cm H2O, p=0.00), time to lowest FiO2 (94±24 versus 435±221 minutes; p=0.000) and O2 dependency (29±12 versus 45±17 days; p=0.04). No adverse events and no differences in the outcomes were observed. LRM led to the earlier lowest FiO2 of the first 12 hours of life and a shorter O2 dependency. [ABSTRACT FROM AUTHOR]

Background: There is no consensus on diagnosis and management of ASBO. Initial conservative management is usually safe, however proper timing for discontinuing non operative treatment is still controversial. Open surgery or laparoscopy are used without standardized indications. Methods: A panel of 13 international experts with interest and background in ASBO and peritoneal diseases, participated in a consensus conference during the 1st International Congress of the World Society of Emergency Surgery and 9th Peritoneum and Surgery Society meeting, in Bologna, July 1-3, 2010, for developing evidencebased recommendations for diagnosis and management of ASBO. Whenever was a lack of high-level evidence, the working group formulated guidelines by obtaining consensus. Recommendations: In absence of signs of strangulation and history of persistent vomiting or combined CT scan signs (free fluid, mesenteric oedema, small bowel faeces sign, devascularized bowel) patients with partial ASBO can be managed safely with NOM and tube decompression (either with long or NG) should be attempted. These patients are good candidates for Water Soluble Contrast Medium (WSCM) with both diagnostic and therapeutic purposes. The appearance of water-soluble contrast in the colon on X-ray within 24 hours from administration predicts resolution. WSCM may be administered either orally or via NGT (50-150 ml) both immediately at admission or after an initial attempt of conservative treatment of 48 hours. The use of WSCM for ASBO is safe and reduces need for surgery, time to resolution and hospital stay. NOM, in absence of signs of strangulation or peritonitis, can be prolonged up to 72 hours. After 72 hours of NOM without resolution surgery is recommended. Patients treated non-operatively have shorter hospital stay, but higher recurrence rate and shorter time to readmission, although the risk of new surgically treated episodes of ASBO is unchanged. Risk factors for recurrences are age <40 years and matted adhesions. WSCM does not affect recurrence rates or recurrences needing surgery when compared to traditional conservative treatment. Open surgery is the preferred method for surgical treatment of strangulating ASBO as well as after failed conservative management. In selected patients and with appropriate skills, laparoscopic approach can be attempted using open access technique. Access in the left upper quadrant should be safe. Laparoscopic adhesiolysis should be attempted preferably in case of first episode of SBO and/or anticipated single band. A low threshold for open conversion should be maintained. Peritoneal adhesions should be prevented. Hyaluronic acid-carboxycellulose membrane and icodextrin can reduce incidence of adhesions. Icodextrin may reduce the risk of re-obstruction. HA cannot reduce need of surgery. [ABSTRACT FROM AUTHOR]

Different approaches are being developed to improve the differentiation of Leishmania genus using biochemical and molecular methods. In this study, 11 independent polymorphic microsatellites were used for the typing of strains of L. infantum isolated in Sicily. Polymerase chain reaction was employed to amplify the microsatellites contained in 12 DNA regions selected from among more investigated loci. A total of 51 isolates of L. infantum from dogs were tested by using the same locus panel. The products were successively analysed using an automatic sequence detector (ABI PRISM 3130 AB), to discover relevant microsatellite polymorphisms. It was possible to discriminate between MON-1 and non-MON-1 groups. Moreover, the method permitted to distinguish various genotypes of L. infantum isolates within each zymodema. Model- and distance-based analyses of the data set showed comparable results. The frequency of heterozygosity in the alleles analysed varied extremely between the different groups of isolates. As the method exhibits a high level of discrimination, it is suitable for characterization of closely related strains in epidemiological studies. [ABSTRACT FROM AUTHOR]

The article discusses proportional representation in the context of Italian parliamentary politics. Among other topics addressed are tensions between proportional representation and the existence of parliamentary groups and permanent committees within parliament, the effect of fascism on the system, and revised regulations of 1971.

Examines the general practitioners' knowledge of the principles of nutrition in Italy. Eating profile in northern Italy; Need to preserve and promote healthier dietary patterns; Difference of dietary habits between northern and southern Italy; Increase in atherogenic serum lipoproteins; Prevalence of obesity and overweight.

The geographical diffusion of leishmaniasis can depend on the factors limiting the distribution of sandfly vectors. In Sicily, as in all Mediterranean areas, sandflies are present almost all year round because the climate permits perpetuation of this vector's life cycle. Transmission can occurs in rural and domestic habitats through the bite of infected female phlebotomine sandflies. In Italy, the visceral form of leishmaniasis is commonly found, which is due exclusively to L. infantum. Two species of sandfly are considered the main vectors: Phlebotomus perniciosus and P. perfiliewi. Fluorescence resonance energy transfer technology was used to determine the parasite load in phlebotomine vectors, and the test was targeted on a 117-bp fragment of kinetoplast DNA minicircles. The assay was evaluated, focusing on analytical sensitivity, discriminatory power, and reliability of quantification. During 2005, a total of 1686 sandflies were trapped in various Sicilian provinces and in farms randomly selected using black light traps. We found 20, 30, and 16 sandflies positive for Leishmania for each kind of analyzed phlebotomine sandfly, respectively, corresponding to 6.5% for the gravid, 2.7% for the fed, and 6.3% for other groups. Previously the insects were identified on the basis of morphology and the most prevalent sandfly species were P. Sergentomyia minuta, P. perfiliewi, and P. perniciosus. [ABSTRACT FROM AUTHOR]

The article clarifies the policy on the taxation of foreign funds investing in Italy. With Ruling 167/E of April 21, 2008 (Ruling 167), the Italian tax authorities clarified the requirements for the treaty entitlement of foreign pension funds. The conclusions reached by the tax authorities are substantially in line with the commentary to the OECD Model Convention (OECD MC). According to the domestic provisions, dividends distributed to non-resident entities are ordinarily subject to a 27% withholding tax. In order to assess who is the effective beneficiary of the income, the tax authorities focused their attention on the issue of whether or not the fon commun de placement (FCP) qualifies as a resident entity under Article 4 of the Luxembourg-Italy tax treaty.

Abstract Background Although optimization of immunosuppressive schemes in renal transplantation have minimized acute posttransplant complications, long-term outcomes are still not optimal and most of the chronic graft damage is drug-related. Therefore, to define the best long-term maintenance immunosuppressive regimen is of major importance in renal transplantation. To assess this objective, we undertook a large, multicenter cohort study in Italy. Methods We retrospectively analyzed data of 5635 patients (enrolled from 1983 to 2012) and we assessed the impact of 3 major immunosuppressive regimens (calcineurin inhibitors+antimetabolites+corticosteroids [CNI+ANT+CS] vs CNI+mammalian target-of-rapamycin (mTOR) inhibitors+CS [CNI+mTOR-I+CS] vs CNI+CS) on long-term clinical outcomes by employing several statistical algorithms. Results The overall difference in the incidence of outcome over time was not statistically different within the first 5 years of follow-up (P =.13); however, it became significant at 10 years and 20 years (P <.01), with the CNI+CS group showing the lowest cumulative incidence of outcome. Compared with the CNI+ANT+CS group, the CNI+mTOR-I+CS group patients had a significantly higher risk of outcome (hazard ratio [HR], 1.30; P =.024); the difference remained significant and even increased in magnitude after adjustment for potential confounders (HR, 1.38; P =.006). Similarly, patients in the CNI+CS group had a significantly higher risk of the outcome (HR, 1.64; P <.001). Conclusion Our data confirm that CNI+ANT+CS is the "gold standard" therapy in renal transplantation, but, whenever required, the introduction of mTOR-Is instead of ANT may not dramatically modify major clinical outcomes. The use of mTOR-I could be a valuable pharmacologic tool to minimize CNI complications and insure adequate immunosuppression. Highlights • Calcineurin inhibitor+antimetabolite+steroid is still the "gold standard" in immunosuppressive therapy. • Mammalian target-of-rapamycin inhibitors (mTOR-Is), instead of antimetabolites, do not modify major long-term clinical outcomes. • mTOR-I+CNI represents a valuable immunosuppressive strategy in transplantation. [ABSTRACT FROM AUTHOR]

We found significant elevated incidence of hypospadias in two towns in Southeastern Sicily selected on the basis of the presence of intense industrial (Augusta) and agricultural (Vittoria) activities. Cases and controls were chosen in records collected from a surveillance system on abnormal live births in the same area and in a large city (Catania) located in an area at low risk of exposure to environmental pollutants. From 1991 to 1998, 16 cases of isolated hypospadias were recorded among male live births in Augusta (12.1 per 1000 male live births) and 24 cases in Vittoria (7.4 per 1000 male live births) with an incidence significantly higher than that expected (3.2 per 1000 in Southeastern Sicily). Relative risks in Augusta and Vittoria were 3.8 (95% confidence interval: 2.16–6.14) and 2.3 (95% confidence interval: 1.48–3.43; P=0.00003 and 0.04, respectively). In Augusta, the incidence of hypospadias was higher than in Vittoria. Significant log odds ratios were found for occupational exposure in fathers both in Augusta and Vittoria (P=0.0478 and 0.026, respectively). However, daily contact with pollutants in Augusta may not be sufficient by itself to determine hypospadias and other factors might be involved. Similar factors may act also in Vittoria. Thus, contact with large amounts of pesticides is, by itself, a risk factor for hypospadias, though genetic and other environmental factors might be involved. [Copyright &y& Elsevier]

This paper takes into consideration landslide phenomena in the clayey slopes facing the built-up area of Pomarico which is situated in the southern part of the “Fossa Bradanica”, in Basilicata (Italy). Based on the great number of geologic, geomorphologic and historic informations a geotechnical model of the slope was built. Particular attention has been paid to define the geotechnical parameters of the soil and which mechanical models are to be used. The studies point out a correlation between the water level in the detritus cover and the stability condition of the slope showing that phenomena at first located at the foot of the slope spread quickly towards its summit as the piezometric height increases. [Copyright &y& Elsevier]